Upper extremity myxofibrosarcoma mimicking an erosive inflammatory arthritis: a case report.

Authors:
Scott E Kilpatrick
Scott E Kilpatrick
Forsyth Medical Center
Winston-Salem | United States
Nathan W Mesko
Nathan W Mesko
Rush University Medical Center
United States
Carl S Winalski
Carl S Winalski
Cleveland Clinic
United States

Skeletal Radiol 2019 Apr 15. Epub 2019 Apr 15.

Imaging Institute, Cleveland Clinic, 9500 Euclid Ave. A21, Cleveland, OH, 44195, USA.

Myxofibrosarcoma is a malignant fibroblastic soft tissue neoplasm containing a variable amount of myxoid stroma that commonly presents as a slow-growing mass in elderly patients. The neoplasm may be superficial or deep to the muscle fascia and characteristically has an infiltrative growth pattern with a dominant or multinodular mass. We describe an unusual case of high-grade myxofibrosarcoma of the wrist and forearm that infiltrated the muscles, tendons, and wrist joint, causing bone erosions. The tumor was mistakenly diagnosed as synovitis and a chronic, erosive, inflammatory process. The diffuse nature, absence of a dominant mass, and radiographic appearance complicated the diagnosis. Although neoplasms of the synovial spaces are rare, this case demonstrates that tumors with a highly infiltrative growth pattern can mimic inflammatory synovitis and that neoplasms should be considered in the differential diagnosis when clinical and laboratory features are discordant with the imaging appearance.

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http://link.springer.com/10.1007/s00256-019-03217-w
Publisher Site
http://dx.doi.org/10.1007/s00256-019-03217-wDOI Listing
April 2019
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